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The purpose of the current Study is to determine the safety and effectiveness of Galnobax® plus Standard of Care versus only Standard of Care, in treating Diabetic Foot Ulcers (DFU). In addition, Study is designed to investigate the safety of Galnobax® vehicle for establishing non-deleterious effects of Vehicle on wound healing in the Subjects with DFU. The study is being conducted in 350 subjects being recruited in about 30 centers in India.
The current study is a Prospective, Multicenter, Randomized, Double-Blind, Phase 3 Study to Evaluate the Safety and Efficacy of a Gel Formulation of Esmolol Hydrochloride (Galnobax®) in Treating Diabetic Foot Ulcers. The study evaluates the safety and effectiveness of Galnobax® plus Standard of Care versus only Standard of Care, in treating Diabetic Foot Ulcers (DFU). In addition, Study is designed to investigate the safety of Galnobax® vehicle for establishing non-deleterious effects of Vehicle on wound healing in the Subjects with DFU.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Galnobax® 14% gel plus SoC | Active Comparator | Galnobax 14% gel along with Standard of Care (SoC) will be administered twice daily (150 subjects) |
|
| SoC Only | Sham Comparator | Only Standard of Care will be administered twice daily (150 subjects) |
|
| Vehicle plus SoC | Placebo Comparator | Vehicle gel along with Standard of Care (SoC) will be administered twice daily (50 subjects) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Esmolol Hydrochloride | Drug | Galnobax-14% gel application along with Standard of Care |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Subjects Achieving Target Ulcer Closure Within 12-week Treatment Phase, as Assessed by Blinded Investigator | Proportion of complete closure of wounds within 12-week treatment phase where Complete wound closure is defined as complete skin re-epithelialization that is without drainage or dressing requirements evaluated in two visits two weeks apart from first observation of closure. | Wound closure assessed up to week 12 and confirmed by 2 visits 2 weeks apart; only participants with wound closure at or before Week 12 and who maintained closure after 4-weeks of follow-up reported |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Subjects Achieving Target Ulcer Closure Till End of Study, as Assessed by the Blinded Investigator. | Proportion of complete closure of wounds at 24-weeks or End of Study where Complete wound closure is defined as complete skin re-epithelialization that is without drainage or dressing requirements. | 24-weeks. The ulcers achieving complete closure till end of study |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Subjects With Treatment Emergent Adverse Events (TEAEs) | Proportion of Treatment emergent adverse events (TEAEs) in all the groups | 24-weeks |
Inclusion Criteria:
Subjects, male or female, aged 18 to 75 years (inclusive) with Type 1 or Type 2 diabetes undergoing therapy for glycemic control
Subject has glycosylated hemoglobin, HbA1C, ≤ 12%
Subject with diagnosis of neuropathic foot ulcer by 10g monofilament test
Subject has adequate vascular perfusion of the affected limb, confirmed by Ankle-Brachial Index (ABI) ≥ 0.65 and ≤ 1.3
Presence of at least one DFU that meets all of the following criteria:
Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Investigator
Subject, if female of child-bearing potential, has a negative urine pregnancy test at Screening and willing to use acceptable methods of contraception (birth control pills, barriers) or abstinence throughout the Study
Subject is able and willing to comply with Study procedures including the use of an off-loading device (as applicable for the location of the ulcer) and adhere to protocol during the Study in the opinion of Investigator
A Subject or LAR agrees to sign informed consent form and allow audio visual recording of consent, if applicable
Exclusion Criteria:
Actively infected ulcers with or without purulent discharge, ulcers with exposed bone or associated with osteomyelitis
Subjects with more than three ulcers below knee
Subjects with Target Ulcer requiring off-loading that cannot be effectively off-loaded; or unable to tolerate the off-loading method
Subject has ulcers caused by a disease other than diabetes, e.g., fungal ulcerations, malignant ulcerations, and ulcerations due to venous or arterial insufficiency, or due to hematological disorders, in the opinion of the Investigator
Ulcer, about which the Investigator is suspicious for cancer
Subjects with a gangrenous or ischemic ulcer
Subject with ulcer that in the opinion of the Investigator, may need amputation
Subject with Target ulcer where wound measurement is not possible, such as ulcers between toes
Body mass index (BMI) > 40 kg/m2
Laboratory values at Screening of:
Presence of any existing clinically significant medical condition(s) that, in the opinion of the Investigator, could interfere with wound healing
Subject has received or is currently receiving or scheduled to receive any medication or therapies during the course of the Study that will modulate wound healing
Subject with intolerance to β-blockers at any time in the past
Has any other factor which may, in the opinion of the Investigator, compromise participation and/or follow-up in the Study
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| Name | Affiliation | Role |
|---|---|---|
| Ashu Rastogi, MD | Post Graduate Institute of Medical Education and Research, Chandigarh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Yalamanchi Hospita | Vijayawada | Andhra Pradesh | 520002 | India | ||
| M.S. Ramaiah Medical College and Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37184839 | Derived | Rastogi A, Kulkarni SA, Agarwal S, Akhtar M, Arsule S, Bhamre S, Bhosle D, Desai S, Deshmukh M, Giriraja KV, Jagannath J, Kashiva RY, Kesavan R, Khandelwal D, Kolte S, Kongara S, Darivemula AK, Madhusudan C, Pyare Saheb Qureshi MAH, Ramu M, Rathod G, Yalamanchi SR, Shakya S, Shetty P, Singh S, Deshpande SK, Viswanathan V, Unnikrishnan AG. Topical Esmolol Hydrochloride as a Novel Treatment Modality for Diabetic Foot Ulcers: A Phase 3 Randomized Clinical Trial. JAMA Netw Open. 2023 May 1;6(5):e2311509. doi: 10.1001/jamanetworkopen.2023.11509. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Galnobax® 14% Gel Plus SoC | Esmolol Hydrochloride gel (Galnobax) administered twice daily along with Standard of Care |
| FG001 | SoC Only | Only Standard of Care administered twice daily |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Nov 28, 2019 |
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Prospective, Multicenter, Randomized, Double-Blind, Parallel groups
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The subject will be masked from the treatment by the Study Nurse (care giver) by using blinder during each treatment application. The site has two separate teams (blinded and unblinded) for masking. The unblinded investigator performs application of treatment during each treatment visit of subject to the site.
| Only Standard of Care | Other | Only Standard of Care treatment |
|
| Vehicle Gel | Other | Vehicle gel application along with Standard of Care |
|
| Bangalore |
| Karnataka |
| 560054 |
| India |
| Sapthagiri Institute of Medical Sciences and Research Centre | Bangalore | Karnataka | 560090 | India |
| Rajlaxmi Hospital | Bangalore | Karnataka | 560097 | India |
| Sri Siddhartha Medical College | Tumkūr | Karnataka | 572107 | India |
| Sujata Birla Hospital & Medical Research Center | Nashik | Maharashtra | 422101 | India |
| Deenanath Mangeshkar Hospital and Research Center | Pune | Maharashtra | 411004 | India |
| Chellaram Diabetes Institute | Pune | Maharashtra | 411021 | India |
| Appollo Hospital | Chennai | Tamil Nadu | 600006 | India |
| M.V. Hospital for Diabetes Pvt Ltd | Chennai | Tamil Nadu | 600013 | India |
| Madras Diabetes Research Foundation | Chennai | Tamil Nadu | 600086 | India |
| Sri Ramachandra Hospital | Chennai | Tamil Nadu | 600116 | India |
| Post Graduate Institute of Medical Education and Research (PGIMER) | Chandigarh | 110012 | India |
| Maharaja Agrasen Hospital | New Delhi | 110026 | India |
| FG002 | Vehicle Plus SoC | Vehicle gel administered twice daily along with Standard of Care |
| COMPLETED |
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| NOT COMPLETED |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Galnobax® 14% Gel Plus SoC | Esmolol Hydrochloride gel (Galnobax) administered twice daily along with Standard of Care |
| BG001 | SoC Only | Only Standard of Care administered twice daily |
| BG002 | Vehicle Plus SoC | Vehicle gel administered twice daily along with Standard of Care |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| ||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| |||||||||||
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
| ||||||||||
| Region of Enrollment | Number | participants |
| |||||||||||
| Body Mass Index | Mean | Standard Deviation | Kg/m2 |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Proportion of Subjects Achieving Target Ulcer Closure Within 12-week Treatment Phase, as Assessed by Blinded Investigator | Proportion of complete closure of wounds within 12-week treatment phase where Complete wound closure is defined as complete skin re-epithelialization that is without drainage or dressing requirements evaluated in two visits two weeks apart from first observation of closure. | Subjects in FAS population | Posted | Count of Participants | Participants | Wound closure assessed up to week 12 and confirmed by 2 visits 2 weeks apart; only participants with wound closure at or before Week 12 and who maintained closure after 4-weeks of follow-up reported |
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| Secondary | Proportion of Subjects Achieving Target Ulcer Closure Till End of Study, as Assessed by the Blinded Investigator. | Proportion of complete closure of wounds at 24-weeks or End of Study where Complete wound closure is defined as complete skin re-epithelialization that is without drainage or dressing requirements. | Posted | Count of Participants | Participants | 24-weeks. The ulcers achieving complete closure till end of study |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Other Pre-specified | Proportion of Subjects With Treatment Emergent Adverse Events (TEAEs) | Proportion of Treatment emergent adverse events (TEAEs) in all the groups | ITT (Safety population) | Posted | Count of Participants | Participants | 24-weeks |
|
|
24 weeks i.e. till end of study
AEs collected from baseline visit i.e. after first application of treatment
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Galnobax® 14% Gel Plus SoC | Galnobax 14% gel along with Standard of Care (SoC) will be administered twice daily (76 subjects) Esmolol Hydrochloride: Galnobax-14% gel application along with Standard of Care | 0 | 76 | 1 | 76 | 9 | 76 |
| EG001 | SoC Only | Only Standard of Care will be administered twice daily (76 subjects) Only Standard of Care: Only Standard of Care treatment | 0 | 76 | 2 | 76 | 7 | 76 |
| EG002 | Vehicle Plus SoC | Vehicle gel along with Standard of Care (SoC) will be administered twice daily (24 subjects) Vehicle Gel: Vehicle gel application along with Standard of Care | 1 | 24 | 4 | 24 | 9 | 24 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cellulitis | Infections and infestations | MedDRA 23.1 or later | Non-systematic Assessment |
| |
| Infected skin ulcer | Infections and infestations | MedDRA 23.1 or later | Systematic Assessment |
| |
| Meningitis bacterial | Infections and infestations | MedDRA 23.1 or later | Systematic Assessment |
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| Septic shock | Infections and infestations | MedDRA 23.1 or later | Systematic Assessment |
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| Wound infection | Infections and infestations | MedDRA 23.1 or later | Systematic Assessment |
| |
| Ligament sprain | Injury, poisoning and procedural complications | MedDRA 23.1 or later | Systematic Assessment |
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| Hypoglycaemic seizure | Nervous system disorders | MedDRA 23.1 or later | Systematic Assessment |
| |
| Acute kidney injury | Renal and urinary disorders | MedDRA 23.1 or later | Systematic Assessment |
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| Atrial fibrillation | Cardiac disorders | MedDRA 23.1 or later | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cellulitis | Infections and infestations | MedDRA 23.1 or later | Non-systematic Assessment |
| |
| Wound infection | Infections and infestations | MedDRA 23.1 or later | Systematic Assessment |
| |
| Hypertension | Vascular disorders | MedDRA 23.1 or later | Systematic Assessment |
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| Acute kidney injury | Renal and urinary disorders | MedDRA 23.1 or later | Systematic Assessment |
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| Neuralgia | Nervous system disorders | MedDRA 23.1 or later | Systematic Assessment |
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| Wound complication | Injury, poisoning and procedural complications | MedDRA 23.1 or later | Systematic Assessment |
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| Urinary tract infection | Infections and infestations | MedDRA 23.1 or later | Systematic Assessment |
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| Infected skin ulcer | Infections and infestations | MedDRA 23.1 or later | Systematic Assessment |
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There is an agreement between the Principal Investigator and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
The sponsor has prepared an integrated clinical/statistical report. As this was a multicenter study, any publication/presentation of data was to include the entire study population. Publication/presentation of data from individual study centers is not allowed without explicit permission from the sponsor.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Supreet K. Deshpande | Novalead Pharma Pvt. Ltd. | 7066233033 | supreet@novaleadpharma.com |
| Aug 25, 2023 |
| Prot_SAP_000.pdf |
| ID | Term |
|---|---|
| D017719 | Diabetic Foot |
| ID | Term |
|---|---|
| D003925 | Diabetic Angiopathies |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D016523 | Foot Ulcer |
| D007871 | Leg Ulcer |
| D012883 | Skin Ulcer |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
| D003929 | Diabetic Neuropathies |
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| ID | Term |
|---|---|
| C036604 | esmolol |
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